目的比较优化短反转恢复(Short TI Inversion Recovery,STIR)和三点非对称法脂肪抑制技术(Iterative Dixon of Water-fat with Echo Asymmetry and Least-squares Estimation,IDEAL)对金属植入物磁共振成像(Magnetic Resonance Imaging,...目的比较优化短反转恢复(Short TI Inversion Recovery,STIR)和三点非对称法脂肪抑制技术(Iterative Dixon of Water-fat with Echo Asymmetry and Least-squares Estimation,IDEAL)对金属植入物磁共振成像(Magnetic Resonance Imaging,MRI)图像质量的影响。方法选取腰椎金属内固定术后需行MRI检查的患者30例,行常规序列以及优化STIR、IDEAL序列扫描,通过对感兴趣区信号的强度值分别计算信噪比(Signal to Noise Ratio,SNR)和信噪比(Contrast to Noise Ratio,CNR),对数据结果做统计学分析;对脂肪抑制均匀性、金属伪影大小进行主观评价。结果优化STIR和IDEAL两种方法图像信噪比分别为:19.26±0.96、20.26±1.24(t=-2.94,P<0.01);图像噪声比分别为:7.03±0.94、8.28±0.97(t=-6.07,P<0.01);主观评分脂肪抑制的均匀性分别为:3.47±0.51、3.63±0.50(t=1.37,P>0.05);金属伪影的大小分别为:3.68±0.67,3.74±0.65(t=-0.57,P>0.05)。结论IDEAL技术在脂肪抑制均匀性、金属伪影、图像信噪比等图像质量方面和优化STIR脂肪抑制技术相当,并且可以得到更好的SNR和CNR。因此在机器条件允许的情况下,对于金属植入物的患者可以选择IDEAL脂肪抑制技术进行检查。展开更多
Objective To evaluate the clinical impact of whole body diffusion weighted imaging （WB-DWI） on diagnosis and staging of malignant lymphoma. Methods Thirty-one patients with suspected lymphadenopathy were enrolled. ...Objective To evaluate the clinical impact of whole body diffusion weighted imaging （WB-DWI） on diagnosis and staging of malignant lymphoma. Methods Thirty-one patients with suspected lymphadenopathy were enrolled. WB-DWI was performed by using short TI inversion recovery echo-planar imaging sequence with free breathing and built-in body coil. Axial T2- weighted imaging images of the same location were used as reference. The results of WB-DWI were compared with pathological results and other imaging modalities. The mean apparent diffusion coefficient （ADC） values of different kinds of lymph nodes were compared. Results WB-DWI was positive in all 18 cases with lymphoma, 5 cases with metastatic lymph nodes and 4 of 8 eases with benign lymphadenopathy. The mean ADC value of lymphomatous, metastatic and benign lymph nodes was （0.87 ± 0.17） × 10^3, （0.98± 0.09） × 10^3 and （1.20 ± 0.10） × 10^3 mm^2/s. There was significant difference in ADC value between benign lymph nodes and other two groups （P 〈 0.01）. The sensitivity, specificity and accuracy of WB-DWI in diagnosis of lymphoma were 100% （18/18）, 30.8% （4/13） and 71.0% （22/31）. When an ADC value of 1.08 × 10^-3 mm^2/s was used as the threshold value for differentiating malignant from benign lymph nodes, the best results were obtained with sensitivity of 87.8% and specificity of 91.3%. Sixteen of eighteen cases （88.9%） of lymphoma were accurately staged in accordance with clinical staging. Conclusions WB-DWI is a sensitive, but less specific technique for diagnosis of lymphoma. It is difficult to differentiate lymphnmatous from metastatic lymph nodes using WB-DWI. However, it is a valuable imaging modality for staging of patients with malignant lymphoma.展开更多
目的:探讨T23D SPACE序列在腰骶丛神经根中的应用及其参数优化。方法:前瞻性招募并收集46名正常志愿者的临床与影像资料,所有志愿者均行常规T23D SPACE(方法A)、优化后T23D SPACE(方法B)磁共振扫描,并比较2种方法的扫描时间,第4~5腰神...目的:探讨T23D SPACE序列在腰骶丛神经根中的应用及其参数优化。方法:前瞻性招募并收集46名正常志愿者的临床与影像资料,所有志愿者均行常规T23D SPACE(方法A)、优化后T23D SPACE(方法B)磁共振扫描,并比较2种方法的扫描时间,第4~5腰神经、第1~4骶神经、坐骨神经的神经显示情况,第5腰神经根节中、节前、节后的信噪比(SNR)、对比度噪声比(CNR)_(神经-肌肉)、对比度(CR)_(神经-肌肉值)。优化后T23D SPACE序列(方法B)主要优化了TR、TE、加速因子(回波链)、脂肪抑制方式、血液抑制方式、层厚等参数。结果:(1)方法A扫描时间为356 s,方法B扫描时间为229 s。(2)在神经显示评分比较中,第4、5腰神经,第1~4骶神经和坐骨神经的显示评分在2种方法之间差异无统计学意义。(3)第5腰神经根的节中SNR值(286.842±75.822 vs 376.784±111.880)、CNR_(神经-肌肉值)(389.199±106.824 vs 522.683±159.883)、CR_(神经-肌肉值)(0.798±0.037 vs 0.830±0.038)在2种方法间比较,差异均有统计学意义(P<0.05)。(4)第5腰神经根的节前SNR值(198.758±52.966 vs 260.378±79.631)、CNR_(神经-肌肉值)(254.720±74.904 vs344.948±112.041)、CR_(神经-肌肉值)(0.718±0.070 vs 0.762±0.056)在2种方法间比较,差异均有统计学意义(P<0.05)。(5)第5腰神经根的节后SNR值(161.400±46.883 vs 206.849±59.706)、CNR_(神经-肌肉值)(197.684±63.776 vs 263.240±80.910)、CR_(神经-肌肉值)(0.663±0.068 vs 0.711±0.058)在2种方法间比较,差异均有统计学意义(P<0.05)。结论:常规T23D SPACE序列与优化后的序列均可以显示腰骶神经,优化后扫描更快,神经显示中第5腰神经根的信噪比、对比度均比常规T23D SPACE序列高。展开更多
目的评价联合非增强磁共振短TI翻转恢复序列(short TI inversion recovery,STIR)及扩散加权成像(diffusion weightedimaging,DWI)在乳腺癌诊断中的价值。方法回顾性研究复旦大学附属华山医院2009年至2009年2月收治的48例经术后病理证实...目的评价联合非增强磁共振短TI翻转恢复序列(short TI inversion recovery,STIR)及扩散加权成像(diffusion weightedimaging,DWI)在乳腺癌诊断中的价值。方法回顾性研究复旦大学附属华山医院2009年至2009年2月收治的48例经术后病理证实的乳腺癌病例,所有病人在术前进行钼靶及MRI DWI(b:500、800、1000)及STIR扫描。联合DWI及STIR对乳腺癌进行诊断,分析诊断的敏感度及假阴性率。分析不同类型乳腺及DWI不同b值情况下的诊断敏感度。结果联合DWI及STIR诊断乳腺癌的敏感度为:91.7%,假阴性率为:8.3%。不同乳腺类型之间诊断敏感度差异无统计学意义(P=0.83>0.05)。不同b值:b值取500、800、1000时诊断敏感度在三者之间差异有统计学意义(x^2=6.5349,P=0.045<0.05)。结论联合非增强磁共振STIR及DWI诊断乳腺癌具有较大价值,为乳腺癌的筛查及随访提供了一种简便的方法。展开更多
分析我院2004年～2007年123例早期股骨头无菌坏死患者的X线平片、CT以及MRI检查。123例患者在MRI检查中应用短时反转恢复(short TI Inversion-Recovery)序列通过抑制正常骨髓高信号及周围肌肉组织间脂肪高信号,使病变早期轻微水肿高信...分析我院2004年～2007年123例早期股骨头无菌坏死患者的X线平片、CT以及MRI检查。123例患者在MRI检查中应用短时反转恢复(short TI Inversion-Recovery)序列通过抑制正常骨髓高信号及周围肌肉组织间脂肪高信号,使病变早期轻微水肿高信号显示出来,诊断早期股骨头无菌坏死,跟踪追查1至3年,93例患者出现股骨头塌陷,临床证实为股骨头无菌坏死,进一步明确诊断。展开更多
Background Detection rate of retropharyngeal lymph node metastasis in patients with nasopharyngeal carcinoma （NPC） needs to be improved. The purpose of this study was to compare three magnetic resonance （MR） seque...Background Detection rate of retropharyngeal lymph node metastasis in patients with nasopharyngeal carcinoma （NPC） needs to be improved. The purpose of this study was to compare three magnetic resonance （MR） sequences for detecting lymph nodes in patients with NPC. Methods Between July 2007 and March 2008, MR staging of pre-treated tumor was conducted on 120 patients with pathologically confirmed NPC. The outcome of three different sequences for MR NPC staging were compared： coronal short T1 inversion recovery （STIR）, axial proton density fat-suppressed （PDWI fs）, and coronal contrast enhanced fast spin echo T1 weighted fat-suppressed （CE FSE TlWl fs）. Nodal classification method （1999） was applied to count the number of retropharyngeal and cervical lymph nodes discovered by each MR sequence. Paired t tests were used for statistical analysis. Results A total of 2575 lymph nodes were found using coronal STIR sequence; 1816 lymph nodes for coronal CE FSE TIWI fs sequence and 2638 lymph nodes for axial PDWl fs sequence. Significant differences existed in the number of lymph nodes detected by axial PDWI fs and coronal CE FSE T1WI fs sequence （paired t test, P 〈0.05）, with the former sequence getting higher numbers. Statistical differences also existed between coronal STIR and coronal CE FSE TlWl fs sequence （paired ttest, P 〈0.05）, with the former sequence getting higher numbers. No significant difference was found between coronal STIR sequence and axial PDWI fs sequence （paired ttest, P 〉0.05）. Conclusions For the detection of retropharyngeal and cervical lymph nodes, coronal STIR sequence and axial PDWI fs sequence have similar performance and both sequences showed better detection than CE FSE TIWI fs sequence. Furthermore, by combining coronal STIR sequence and axial PDWI fs sequence, we can improve the detection of lymph nodes in NPC N-staging before treatment, especially for lymph nodes located in the thoracic entrance.展开更多
文摘目的比较优化短反转恢复(Short TI Inversion Recovery,STIR)和三点非对称法脂肪抑制技术(Iterative Dixon of Water-fat with Echo Asymmetry and Least-squares Estimation,IDEAL)对金属植入物磁共振成像(Magnetic Resonance Imaging,MRI)图像质量的影响。方法选取腰椎金属内固定术后需行MRI检查的患者30例,行常规序列以及优化STIR、IDEAL序列扫描,通过对感兴趣区信号的强度值分别计算信噪比(Signal to Noise Ratio,SNR)和信噪比(Contrast to Noise Ratio,CNR),对数据结果做统计学分析;对脂肪抑制均匀性、金属伪影大小进行主观评价。结果优化STIR和IDEAL两种方法图像信噪比分别为:19.26±0.96、20.26±1.24(t=-2.94,P<0.01);图像噪声比分别为:7.03±0.94、8.28±0.97(t=-6.07,P<0.01);主观评分脂肪抑制的均匀性分别为:3.47±0.51、3.63±0.50(t=1.37,P>0.05);金属伪影的大小分别为:3.68±0.67,3.74±0.65(t=-0.57,P>0.05)。结论IDEAL技术在脂肪抑制均匀性、金属伪影、图像信噪比等图像质量方面和优化STIR脂肪抑制技术相当,并且可以得到更好的SNR和CNR。因此在机器条件允许的情况下,对于金属植入物的患者可以选择IDEAL脂肪抑制技术进行检查。
文摘Objective To evaluate the clinical impact of whole body diffusion weighted imaging （WB-DWI） on diagnosis and staging of malignant lymphoma. Methods Thirty-one patients with suspected lymphadenopathy were enrolled. WB-DWI was performed by using short TI inversion recovery echo-planar imaging sequence with free breathing and built-in body coil. Axial T2- weighted imaging images of the same location were used as reference. The results of WB-DWI were compared with pathological results and other imaging modalities. The mean apparent diffusion coefficient （ADC） values of different kinds of lymph nodes were compared. Results WB-DWI was positive in all 18 cases with lymphoma, 5 cases with metastatic lymph nodes and 4 of 8 eases with benign lymphadenopathy. The mean ADC value of lymphomatous, metastatic and benign lymph nodes was （0.87 ± 0.17） × 10^3, （0.98± 0.09） × 10^3 and （1.20 ± 0.10） × 10^3 mm^2/s. There was significant difference in ADC value between benign lymph nodes and other two groups （P 〈 0.01）. The sensitivity, specificity and accuracy of WB-DWI in diagnosis of lymphoma were 100% （18/18）, 30.8% （4/13） and 71.0% （22/31）. When an ADC value of 1.08 × 10^-3 mm^2/s was used as the threshold value for differentiating malignant from benign lymph nodes, the best results were obtained with sensitivity of 87.8% and specificity of 91.3%. Sixteen of eighteen cases （88.9%） of lymphoma were accurately staged in accordance with clinical staging. Conclusions WB-DWI is a sensitive, but less specific technique for diagnosis of lymphoma. It is difficult to differentiate lymphnmatous from metastatic lymph nodes using WB-DWI. However, it is a valuable imaging modality for staging of patients with malignant lymphoma.
文摘目的:探讨T23D SPACE序列在腰骶丛神经根中的应用及其参数优化。方法:前瞻性招募并收集46名正常志愿者的临床与影像资料,所有志愿者均行常规T23D SPACE(方法A)、优化后T23D SPACE(方法B)磁共振扫描,并比较2种方法的扫描时间,第4~5腰神经、第1~4骶神经、坐骨神经的神经显示情况,第5腰神经根节中、节前、节后的信噪比(SNR)、对比度噪声比(CNR)_(神经-肌肉)、对比度(CR)_(神经-肌肉值)。优化后T23D SPACE序列(方法B)主要优化了TR、TE、加速因子(回波链)、脂肪抑制方式、血液抑制方式、层厚等参数。结果:(1)方法A扫描时间为356 s,方法B扫描时间为229 s。(2)在神经显示评分比较中,第4、5腰神经,第1~4骶神经和坐骨神经的显示评分在2种方法之间差异无统计学意义。(3)第5腰神经根的节中SNR值(286.842±75.822 vs 376.784±111.880)、CNR_(神经-肌肉值)(389.199±106.824 vs 522.683±159.883)、CR_(神经-肌肉值)(0.798±0.037 vs 0.830±0.038)在2种方法间比较,差异均有统计学意义(P<0.05)。(4)第5腰神经根的节前SNR值(198.758±52.966 vs 260.378±79.631)、CNR_(神经-肌肉值)(254.720±74.904 vs344.948±112.041)、CR_(神经-肌肉值)(0.718±0.070 vs 0.762±0.056)在2种方法间比较,差异均有统计学意义(P<0.05)。(5)第5腰神经根的节后SNR值(161.400±46.883 vs 206.849±59.706)、CNR_(神经-肌肉值)(197.684±63.776 vs 263.240±80.910)、CR_(神经-肌肉值)(0.663±0.068 vs 0.711±0.058)在2种方法间比较,差异均有统计学意义(P<0.05)。结论:常规T23D SPACE序列与优化后的序列均可以显示腰骶神经,优化后扫描更快,神经显示中第5腰神经根的信噪比、对比度均比常规T23D SPACE序列高。
文摘分析我院2004年～2007年123例早期股骨头无菌坏死患者的X线平片、CT以及MRI检查。123例患者在MRI检查中应用短时反转恢复(short TI Inversion-Recovery)序列通过抑制正常骨髓高信号及周围肌肉组织间脂肪高信号,使病变早期轻微水肿高信号显示出来,诊断早期股骨头无菌坏死,跟踪追查1至3年,93例患者出现股骨头塌陷,临床证实为股骨头无菌坏死,进一步明确诊断。
基金This study was supported by a grant from the Natural Science Foundation of Fujian Province （No. 2004Y008）.
文摘Background Detection rate of retropharyngeal lymph node metastasis in patients with nasopharyngeal carcinoma （NPC） needs to be improved. The purpose of this study was to compare three magnetic resonance （MR） sequences for detecting lymph nodes in patients with NPC. Methods Between July 2007 and March 2008, MR staging of pre-treated tumor was conducted on 120 patients with pathologically confirmed NPC. The outcome of three different sequences for MR NPC staging were compared： coronal short T1 inversion recovery （STIR）, axial proton density fat-suppressed （PDWI fs）, and coronal contrast enhanced fast spin echo T1 weighted fat-suppressed （CE FSE TlWl fs）. Nodal classification method （1999） was applied to count the number of retropharyngeal and cervical lymph nodes discovered by each MR sequence. Paired t tests were used for statistical analysis. Results A total of 2575 lymph nodes were found using coronal STIR sequence; 1816 lymph nodes for coronal CE FSE TIWI fs sequence and 2638 lymph nodes for axial PDWl fs sequence. Significant differences existed in the number of lymph nodes detected by axial PDWI fs and coronal CE FSE T1WI fs sequence （paired t test, P 〈0.05）, with the former sequence getting higher numbers. Statistical differences also existed between coronal STIR and coronal CE FSE TlWl fs sequence （paired ttest, P 〈0.05）, with the former sequence getting higher numbers. No significant difference was found between coronal STIR sequence and axial PDWI fs sequence （paired ttest, P 〉0.05）. Conclusions For the detection of retropharyngeal and cervical lymph nodes, coronal STIR sequence and axial PDWI fs sequence have similar performance and both sequences showed better detection than CE FSE TIWI fs sequence. Furthermore, by combining coronal STIR sequence and axial PDWI fs sequence, we can improve the detection of lymph nodes in NPC N-staging before treatment, especially for lymph nodes located in the thoracic entrance.
